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The Evaluation of the Relationship Between ADC Values and Gleason Score in the Prostate Cancer
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Original Article
VOLUME: 56 ISSUE: 1
P: 53-59
2023

The Evaluation of the Relationship Between ADC Values and Gleason Score in the Prostate Cancer

Acta Haematol Oncol Turc 2023;56(1):53-59
DOI: 10.5505/aot.2023.81488
Şehnaz Tezcan 1
Funda Ulu Öztürk 2
1. Koru Hospital, Radiology Department
2. Baskent University School of Medicine, Radiology Department
3.
No information available.
No information available
Received Date: 2022-06-01T23:34:14
Accepted Date: 2023-04-03T07:14:29
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Abstract

INTRODUCTION

The purpose of this study was to evaluate the apparent diffusion coefficient (ADC) values of different grades of prostate cancer (PC) and determine whether the use of ADC values could predict the tumor aggressiveness in PC.

METHODS

47 patients (Gleason score (GS) ≥ 6) who underwent prostate multi-parametric MRI (1.5 Tesla) between January 2017 and December 2020 for the evaluation of suspicious findings on clinical or laboratory evaluation were enrolled in this study. The specimens which were obtained from systematic 12-core trans-rectal ultrasound (TRUS)-guided biopsy were used for histopathologic diagnoses. The average ADC values within the tumors were calculated. Independent sample t-test, one-way analysis of variance (ANOVA, Tukey’s post-hoc or Tamhane) and receiver operating characteristics (ROC) curve analysis were used.

RESULTS

The mean ADC value of high-risk patients which was 585.4±138.7×10-6 mm2 /s, was significantly lower than other subgroups (p=0.036). The mean ADC value in low-risk group (798.1±236.5 ×10-6 mm2/s) was significantly higher (p = 0.012) than others. No significant difference in ADC values was found between low-risk vs intermediate-risk groups (p = 0.149) and intermediaterisk vs high-risk groups (p = 0.419). No statistically significant difference in ADC values between GS 3+4 and GS 4+3 (p, 0.552) was found. ROC analysis revealed an optimal ADC cut-off of 595×10-6 mm2/s for differentiating high-risk group from the other subgroups (sensitivity, 71%; specificity 67.6%, p, 0.038). For the determination of low-risk group, an ADC cut-off of 665×10-6 mm2/s (sensitivity, 80%; specificity, 65.6%, p, 0.017) was found.

DISCUSSION AND CONCLUSION

While ADC values may differentiate the high-risk and low-risk tumors, the strength of ADC in the prediction of intermediate-risk tumors was low. The ADC cut-off value of 665×10-6 mm2/s showed the high sensitivity and moderate specificity for the detection of low-risk tumors.